title: Clinical efficacy and prognosis factors for advanced hepatoblastoma in children: a 6-year retrospective study.
abstract: OBJECTIVE
  This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis.
  
  
  METHODS
  A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month.
  
  
  RESULTS
  Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP) , and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001).
  
  
  CONCLUSIONS
  Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.
authors.affiliation: Department of Pediatrics of Beijing Tongren Hospital, Capital Medical University, Beijing, China E-mail : Hds5180@sina.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wei-Ling
authors.initials: WL
authors.lastname: Zhang
authors.forename: Dong-Sheng
authors.initials: DS
authors.lastname: Huang
authors.forename: Liang
authors.initials: L
authors.lastname: Hong
authors.forename: Yi-Zhuo
authors.initials: YZ
authors.lastname: Wang
authors.forename: Xia
authors.initials: X
authors.lastname: Zhu
authors.forename: Hui-Min
authors.initials: HM
authors.lastname: Hu
authors.forename: Pin-Wei
authors.initials: PW
authors.lastname: Zhang
authors.forename: You
authors.initials: Y
authors.lastname: Yi
authors.forename: Tao
authors.initials: T
authors.lastname: Han
mesh_terms: D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D018197:Hepatoblastoma / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000509:alpha-Fetoproteins